A case study – Primary prevention and early diagnosis of Rheumatoid Arthritis (RA), Poland

  • A pilot programme for the years 2016-2020, closely associated with government priorities in health, demographic policy and operational objectives related to spending of European funds in the short term
  • Target population of the programme include both GPs and RA patients:
    • Programme addressed to all physicians working in the Primary Health Care in Poland (22 000). It is assumed to train at least 815 doctors
    • Number of patients with diagnosis of RA – 11 000 per year (incidence of 27.5 per 100 000)
    • Number of patients screened – 36 000 per year (accuracy of diagnoses made by GPs – 30% – patients with RA / patients referred to rheumatologist by GP with suspicion of RA)
  • The purpose of the programme: to eliminate / minimalize diagnostic delays and improve early detection of RA in order to keep RA patients in the labor market
    • Establish the Early RA Diagnosis Centers – cooperation between GPs and rheumatologists
    • Introduce diagnostic procedures for early detection of rheumatoid arthritis as part of outpatient care
    • Educate in the field of diagnosis of RA – increasing knowledge, awareness and skills of GPs, nurses and patients
  • Planed interventions:
    • Education of medical personnel (GPs and nurses) and patients
    • Screening: Consultation with GP ->
      • Visit to rheumatologist to verify diagnosis ->
      •   Visit to rheumatologist to confirm diagnosis and introduce effective treatment


  • Main effectiveness measures:
    • Time from first visit of patient with early RA symptoms to a GP to the first visit to a rheumatologist (expected maximum time –  6 weeks)
    • Time from first visit of patient with early RA symptoms to a GP to the final diagnosis and treatment initiation (expected maximum time – 12 weeks)
    • Accuracy of diagnoses made by GPs (the expected percentage of patients with RA diagnosis confirmed by a rheumatologist at the level of 70% (among all patients referred to a rheumatologist by GPs)

Detailed diagnostic path, i.e. screening activities undertaken within the Polish RA programme are shown in the diagram below

Fit for Work Global Alliance is led by The Work Foundation and supported by AbbVie.

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Fit for Work Global Alliance is a multi-stakeholder initiative, driving policy and practice change across the work and health agendas in Europe and worldwide (over 35 countries). The vision is to raise awareness of the facts of MSKs and make the case for more investment in sustainable healthcare by promoting and supporting the implementation of early intervention practices. Fit for Work is led by The Work Foundation – Lancaster University, which is also providing the Secretariat. AbbVie is founding sponsor since 2008. All the research is produced independently by The Work Foundation, with full editorial control resting with the think-thank alone.

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